4.5 mo frequent feeds / slow gain advice pls

[camdenflick]

My LO was feeding every two hours during the day and doing a regular 4 hour stretch of sleep in the evening (with occasional 7 hour stretches) followed by hourly feeds till morning till he was 14 weeks old. Then he suddenly stopped and began feeding every hour, day and night (he's in a sidecar cot and we co-sleep when I give up putting him back at night). He was born above the 70th percentile but is now, at nearly 18 weeks, down to the 9th. I'm worried about his slow gain but also finding it difficult to cope with such interrupted sleep (I also have a 3 year old at home with me). I went to a BF support group the other day and was advised to feed him hourly for an hour (half an hour each side but he falls asleep quite a lot) and was told that I wasn't eating enough calories myself to produce hindmilk (the fatty stuff) - DS has lots of wet nappies but slow gain. I'm now eating for England, lots of carbs and fat, drinking lots of water and taking a fenugreek drink thing (bleughk). But, still no change in DS's feeding pattern, he still wants to feed too frequently and I have to wait till next Wednesday to weigh him. The midwife said I have to have a clear hour in between the end of one feed and the beginning of the next to produce adequate hindmilk, so I'm trying to stick to schedule. I'm desperate for a bit more sleep (four consecutive hours seems like a real luxury now), for DS to pick up a bit more weight and to not have to supplement. I'm hoping a mumsnetter will have the magic answer?

Apologies for the long and slightly incoherent post...

mmm, sounds very tiring camdenflick
...not sure I agree with the advice from your bf group to be honest

-what you eat and drink has no effect on the quality or quantity of your milk. It's a myth that it does.
-The hourly feeding just sounds too tiring (for him and you )- surely if you are feeding him hourly for an hour- then that is just non stop ?

How is he in himself? You say he has lots of wet nappies... Could it be the 4 month growth spurt that is making him want to feed every hour? Is he still putting on weight, even if he has jumped down the centiles?

Sorry to ramble, just putting down thoughts of the top of my head

Odd advice from the bf group - who is in charge?

The fat quantity of your milk is entirely unaffected by diet.

The midwife's view of hindmilk is just wrong, wrong, wrong - are you sure she said that?

It may be your little one needs frequent feeding at the moment, and scheduling will not help.

It seems to me you need some assessment from people who understand about breastfeeding better, to be honest - it's unusual for a baby drop down the centiles like this but it can certainly happen with nothing being wrong at all. But I think you need to see someone to have a really good discussion about it.

Sorry, crikeybadger, I wasn't clear - she said I had to try to feed him for an hour then have an hour with no BF, followed by another hour on the boob etc. He's generally a happy chap, but gain very slowly - midwife said she'd expect him to gain 120g per week and he gained just 40g for the last two weeks.

I wasn't convinced by what she said regarding my diet - I'm sure I've read that mothers can breastfeed in famine conditions?

tiktok, the group I went to was at the hospital where I gave birth. TBH I've had some fantastically bad advice from HVs and midwives but I couldn't find a BF group so went to the hospital one. I have called various support lines though (LLL, NCT, ABM etc) with not much luck.

How could he be eating so much and not gaining? The hindmilk/formilk thing does make sense - if he's drinking loads and not gaining doesn't that mean he's getting low calorie stuff? My latch seems ok and I do hear him glugging away at let down so he's eating something.

And could it really be a growth spurt that lasts so long? I thought they fed regularly for just a couple of days to increase supply.

Would you have any recommendations for who I might be able to speak to about this? I'm getting a bit desperate...
Thanks for your replies.

Check your numbers and try the helplines again, camdenflick - I know NCT's line's message service has had tech problems over the past couple of weeks, so it's worth trying again now.

The other thing to check is the way his weight has been taken - it is not impossible he has been plotted incorrectly, or perhaps imperial/metric has been confused/mistranslated (I hear and see this occasionally) or even that his birth weight was recorded wrongly. A 40g weight gain in 2 weeks means nothing good or bad by the way, in a healthy baby.

You say "How could he be eating so much and not gaining? The hindmilk/formilk thing does make sense - if he's drinking loads and not gaining doesn't that mean he's getting low calorie stuff? "

No, I don't think so. Milk is not made in two different ways - check out the foremilk/hindmilk info on www.kellymom.com for an explanation of this. Poor latch/ineffective suck might be an explanation for a much younger baby, or one who has had weight gain probs from the beginning. Your ds may just need more bf at the moment for behavioural/comfort reasons, or maybe he's been fighting off a virus....I cant stress enough, all this needs checking out by someone who knows what they are talking about, and can seek an explanation for the weight thing, if there is one. There might be no explanation - just this is the way he is at the moment! OTOH, maybe there is something going on - but people who think you need to eat more to make 'hindmilk' and who suggest daft schedules like feed for an hour, rest and feed another hour, are not the people to see, to be quite honest